Evidence map›Paper›PMID 31467391›Full record

ArticleProstate cancer and prostatic diseases2020

Regular vs. selective use of closed suction drains following robot-assisted radical prostatectomy: results from a regional quality improvement collaborative.

Samer W Kirmiz, Stephen Babitz, Susan Linsell, Ji Qi, Christopher M Brede, David C Miller, James E Montie, Brian R Lane, Michigan Urological Surgery Improvement Collaborative

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In one paragraph

Article in Prostate cancer and prostatic diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Samer W KirmizMichigan State University College of Human Medicine, Grand Rapids, MI, USA.
Stephen BabitzSpectrum Health Hospital System, Grand Rapids, MI, USA.
Susan LinsellDepartment of Urology, University of Michigan, Ann Arbor, MI, USA.
Ji QiDepartment of Urology, University of Michigan, Ann Arbor, MI, USA.
Christopher M BredeSpectrum Health Hospital System, Grand Rapids, MI, USA.
David C MillerDepartment of Urology, University of Michigan, Ann Arbor, MI, USA.
James E MontieDepartment of Urology, University of Michigan, Ann Arbor, MI, USA.
Brian R LaneMichigan State University College of Human Medicine, Grand Rapids, MI, USA. brian.lane@spectrumhealth.org.
Michigan Urological Surgery Improvement Collaborative
Spectrum Health · USGrand Rapids Community College · USUniversity of Michigan · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClosed suction drain (CSD) placement is common in robot-assisted radical prostatectomy (RARP). Our goal is to quantify outcomes of RARP for patients undergoing RARP by surgeons who regularly or selectively use CSDs.

methodsPatients undergoing RARP (4/2014-7/2017) were prospectively entered into the Michigan Urological Surgery Improvement Collaborative (MUSIC) registry. Outcomes included length of stay (LOS) >2 days, >16-day catheterization, 30-day readmission, and clinically significant urine leak or ileus. Retrospective analysis of each adverse event was performed comparing groups using chi-square tests.

resultsIn all, 6746 RARPs were performed by 115 MUSIC surgeons. CSDs were used in 4451 RARP (66.0%), with wide variation in surgeon CSD use (median: 94.7%, range: 0-100%, IQR: 45-100%). The cohorts of patients treated by surgeons with regular vs. selective CSD usage were similar. CSD use pattern was not associated with rates of prolonged catheterization (4.6% vs. 3.9%, p = 0.17) or readmission (4.5% vs. 4.0%, p = 0.35) and multivariable analysis confirmed these findings (each p > 0.10). Regular CSD use was associated with LOS >2 days (8.4% vs. 6.3%, p = 0.001) and multivariable analyses indicated an odds ratio (OR) of 1.42 (95% CI: 1.12-1.79; p = 0.017) and increased likelihood of clinically significant ileus (OR: 1.64; CI: 1.14-2.35; p = 0.008).

conclusionsAlthough there are specific situations in which CSDs are beneficial, e.g. anastomotic leak or observed lymphatic drainage, regular CSD use during RARP was associated with a greater likelihood of LOS >2 days and clinically significant ileus. Our data suggest that CSD should be placed selectively rather than routinely after RARP.

Indexed as

ProstatectomyRobotic Surgical ProceduresSuctionAgedClinical Decision-MakingCombined Modality TherapyDisease ManagementHumansLength of StayMaleMichiganMiddle AgedProstatic NeoplasmsQuality ImprovementQuality of Health CareRegistries

Identifiers

PMID31467391
OpenAlexW2970862935

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.